America and indeed the world are watching as the U.S. Congress fails once again to come together and work to craft a budget that addresses the people’s business and the pressing issues that face our planet.

Congress has effectively operated in a vacuum of unexamined assumptions, neglecting opportunities to really assess priorities and spending. Energy policy, environmental sustainability and nuclear weapons programs are existential issues, ignored at our peril. The connections between these issues are more than most recognize. Congressional failure to prioritize the available solutions threatens us all.

First Congress seems to assume by its collective inaction that we can continue our current levels of consumption and reliance on fossil fuel burning into the future without consequence. Yet scientific studies indicate that we may only be able to burn ~20 percent of our remaining oil and gas reserves before we effectively cook the planet. With each year we witness more devastating storms, fires, and coastal hurricanes while globally witnessing a growing desert and famine across the Africa. As an M.D., I am concerned that from a health standpoint, the National Academy of Sciences reports that burning fossil fuels results in about $120 billion in annual health costs. Where is the congressional consensus, leadership and courage to urgently secure our future through sustainable and renewable energy sources, green business support and development? And yet the oil industry continues to receive billions in annual subsidies. At a time of record industry profits, is this fiscally prudent?

Natural resource depletion results from these climatic changes. From growing desertification and loss of farmland to depleted water availability, tensions and conflict both regional and international result. These tensions can and do result in war. And regional wars have a way of drawing in international players trying to protect their “own” resources. In a world armed many times over with nuclear weapons, all war has the potential to go nuclear, either by design or accident.

This brings up the second critical unexamined assumption: that we can continue to survive while maintaining a nuclear arsenal of ~8,000 weapons. According to a recent report by Physicians for Social Responsibility, a tiny fraction of our current arsenal, only 100 Hiroshima-sized bombs, could devastate the world by causing climate disruption and threaten a billion people with starvation coming from a decade of drastic reductions in grain harvests. The very existence of these weapons guarantees that the arms race will continue enticing non-nuclear nations to go nuclear. In addition, such huge arsenals around the world increase the chance of weapons ending up in the wrong hands. These are weapons that can not and must not ever be used—weapons that even retired vice-chairman of the Joint Chiefs of Staff and former nuclear forces commander, Gen. James Cartwright says could be reduced today to 900 weapons.

The cost of maintaining the U.S. nuclear arsenal is ~ $56 billion annually with planned increases to $64 billion annually in the next few years. The nuclear weapons complex has become a grossly expensive jobs program with a life of its own. This was never the intent of the program. The opportunity cost of these wasteful programs to states grappling with the $85 billion sequestration revenue shortfall is obvious. By comparison the cost of nuclear weapons programs alone to states is remarkable. For example, the following Republican-governed states reeling from economic crises and the potential effects of the budget sequestration will see Florida spending ~$3.4 billion on nuclear weapons programs this year while New Jersey will spend ~$1.6 billion and Louisiana ~$821 million. Is this really the answer to their security and future? Fewer jobs are created per $billion spent on nuclear weapons than any category of budget spending, so every$billion spent on the nuclear arsenal is a direct reduction in jobs.

So with this third round of fiscal brinksmanship Congress has a real opportunity and responsibility to look at the tremendous wasteful spending on nuclear weapons and subsidies to the oil industry. Let’s hope—and insiste—they can come together and muster the courage to address the greatest threats to our nation and future. Each of us has a responsibility to let our leaders know where our priorities are. Silence implies consent.